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INTRODUCTION The Health Belief Model (HBM) is one of the first theories of health behavior. It was developed in the 1950s by a group of U.S. Public Health Service social psychologists who wanted to explain why so few people were participating in programs to prevent and detect disease. HBM is a good model for addressing problem behaviors that evoke health concerns (e.g., high-risk sexual behavior and the possibility of contracting HIV) (Croyle RT, 2005) The health belief model proposes that a person's health-related behavior depends on the person's perception of four critical areas: 1. The severity of a potential illness, 2. The person's susceptibility to that illness, 3. The benefits of taking a preventive action, and 4. The barriers to taking that action. HBM is a popular model applied in nursing, especially in issues focusing on patient compliance and preventive health care practices. The model postulates that health-seeking behaviour is influenced by a persons perception of a threat posed by a health problem and the value associated with actions aimed at reducing the threat. HBM addresses the relationship between a persons beliefs and behaviors. It provides a way to understanding and predicting how clients will behave in relation to their health and how they will comply with health care therapies. THE MAJOR CONCEPTS AND DEFINITIONS OF THE HEALTH PROMOTION MODEL There are six major concepts in HBM: 1. Perceived Susceptibility

2. 3. 4. 5. 6.

Perceived severity Perceived benefits Perceived costs Motivation Enabling or modifying factors

Define Perceived Susceptibility One's opinion of chances of getting a condition






personalize risk based on a person's features or behavior; heighten perceived susceptibility if too low.

Perceived Severity

One's opinion of how serious a condition and its Specify consequences of the risk and the consequences are condition

Perceived Benefits

One's belief in the efficacy of the advised action Define action to take; how, where, when; clarify to reduce risk or seriousness of impact the positive effects to be expected.

Perceived Barriers

One's opinion of the tangible and psychological Identify and reduce barriers through reassurance, costs of the advised action incentives, assistance. Provide how-to information, promote awareness, reminders.

Cues to Action

Strategies to activate "readiness"


Confidence in one's ability to take action

Provide training, guidance in performing action.

1. Perceived Costs: refers to the complexity, duration, and accessibility and accessibility of the treatment. 2. Motivation: includes the desire to comply with a treatment and the belief that people should do what.

3. Modifying factors: include personality variables, patient satisfaction, and sociodemographic factors. Strengths: Common-sense constructs easy for non-psychologists to assimilate and apply Has focused research attention on modifiable psychological prerequisites of behavior Makes testable predictions Limitations: Common-sense framework simplifies health-related representational processes Theoretical components broadly defined therefore different operationalisations may not be strictly comparable Lack of specification of a causal ordering Neglects social factors

Criticisms of HBM

Is health behaviour that rational? Its emphasis on the individual (HBM ignores social and economic factors) The absence of a role for emotional factors such as fear and denial. Alternative factors may predict health behaviour, such as outcome expectancy (whether the person feels they will be healthier as a result of their behaviour) and self-efficacy (the persons belief in their ability to carry out preventative behaviour)